Am I Eligible for Dental Services Through Medi-Cal?
The Medi-Cal program provides an array of benefits to its members, including comprehensive coverage for dental services.
Eligibility for Medi-Cal is a prerequisite to access dental coverage through the program. The types of benefits available to you via Medi-Cal are determined by your eligibility status.
Notably, there is no separate application required for dental coverage, as it is an integrated component of the overall Medi-Cal program.
What Dental Services Are Provided for Children?
For Children aged 5-12, the Medi-Cal Dental Program offers a range of complimentary or low-cost dental services, including:
- Dental examinations (every 6 months)
- X-rays
- Teeth cleaning (every 6 months)
- Fluoride varnish applications (every 6 months)
- Molar sealants
- Fillings
- Root canals
- Tooth removal
- Emergency services
- Outpatient services
- Sedation (if medically necessary)
For Teens aged 13-17, the Medi-Cal Dental Program provides the following cost-effective services:
- Dental examinations (every 6 months)
- X-rays
- Fluoride varnish applications (every 6 months)
- Molar sealants
- Teeth cleaning (every 6 months)
- Orthodontics (braces) for qualifying individuals
- Fillings
- Crowns (coverage for molars or premolars in some cases)
- Root canals
- Partial and full dentures
- Scaling and root planning
- Tooth removal
- Emergency services
- Outpatient services
- Sedation (if medically necessary)
What is the Annual Limit for Dental Coverage Under Medi-Cal?
Exciting update:
Children receive comprehensive dental coverage with no annual maximum limit for covered services. Also, adults residing in nursing facilities enjoy unlimited coverage.
For individuals aged 21 and above, there is no cap on benefits for medically necessary treatments. Although, for other services, there is an annual maximum limit of $1800 for the benefits provided each year.
How Can I Locate a Dentist Who Accepts Medi-Cal?
To locate a dentist, you can explore the provider directory on the Medi-Cal Dental website or contact the Telephone Service Center Phone Line at 1-800-322-6384.
- For valuable resources, visit the Smile, California website – Medi-Cal Dental Materials section at https://smilecalifornia.org/members/. Here, you can access brochures and flyers available in various threshold languages.
- If you prefer information in Spanish, check out Smile, California’s Spanish-language website at https://sonriecalifornia.org/.
- For engaging content, including videos and messages, head to https://smilecalifornia.org/videos/ on the Smile, California website.
Feel free to utilize these sources to access relevant and helpful materials regarding dental care in California.
FAQs:
How do I check eligibility for my child’s dental services?
Ensure eligibility for overall Medi-Cal to access integrated dental coverage for your child, with no separate application required.
What services are covered for children and teens under Medi-Cal?
- For kids (5-12): exams, X-rays, cleanings, fillings, and more.
- Teens (13-17) get additional services, including orthodontics and sedation.
Is there an annual limit, and how do I find a Medi-Cal dentist?
- No limit for children and nursing facility adults; $1800 cap for others.
- Locate a dentist on the Medi-Cal Dental website or call 1-800-322-6384. Resources in various languages are available on the Smile, California website, including Spanish.
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